Suggest Treatment For Unbearable Pressure And Pain In Hand And Wrist
 
                                    
                                    
                                          
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                                           Wed, 30 Sep 2015
                                           
                                        
                                        
                                        
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                                                Wed, 30 Sep 2015
                                                
                                            
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                                                Wed, 21 Oct 2015
                                                
                                                
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                                            Question : recent carpal tunnel release..now almost unbearable  ..pressure in hand and wrist, minimal swelling,  intermittent burning, mottling of hand and forearm, toothache like ache in forearm, and also intermittent temp changes...becomes quite cold...great radial pulse, brisk capillary refill. Neg venous US and CT normal without contrast, non contrast MRI  of hand and LIMITED wrist shows normal median nerve caliber and intensity, minimal fld in carpal tunnel with intermediate signal in carpal tunnel, intact Guyon's tunnel...has truly been the WORST pain in my life...any thoughts??any further studies you would recommend??...becoming desperate...lyrica helps but NEVER pain free..increases with minimal use..med too sedating...second surgeon has since done rpt rt carpal tunnel release, release of ulnar nerve and artery, median nerve and palmar cutaneous branch of same... all entrapped in scar tissue, and axogen nerve wraps to median and palmar cutaneous nerves. Instant relief of pressure, able to move fingers independently...which was imposible after 1st CTR, no burning or electric shocks initially post op 2nd CTR, but now having return of some symptoms and EMG and NC studies show CTS in both hands...rt worse than left...still have the temp changes and mottling intermiitently and ache in forearm again.
                            
                                    Brief Answer:
Possible Vascular Occlusion-Need an Early arterial/duplex ultrasound.
Detailed Answer:
Hello, Madam.
I understand your concern.
I have gone through your query in detail.
With your current symptoms the possibility of vascular(arterial thrombosis) is high.
Such events are possible after surgery on hand and nerves.
It is highly important that you get a Color doppler duplex ultrasound of the involved extremity.
Further management(thrombolysis) -medical or surgical is based on test results.
Post your further queries if any,
Thank you.
                                    
                                    
                                    
                                    
                                    
                            Possible Vascular Occlusion-Need an Early arterial/duplex ultrasound.
Detailed Answer:
Hello, Madam.
I understand your concern.
I have gone through your query in detail.
With your current symptoms the possibility of vascular(arterial thrombosis) is high.
Such events are possible after surgery on hand and nerves.
It is highly important that you get a Color doppler duplex ultrasound of the involved extremity.
Further management(thrombolysis) -medical or surgical is based on test results.
Post your further queries if any,
Thank you.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Neel Kudchadkar
                                  
                              
                                         
 
                                    
                                    
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